More Articles

The Dispatch E-Edition

All current subscribers have full access to Digital D, which includes the E-Edition and
unlimited premium content on Dispatch.com, BuckeyeXtra.com, BlueJacketsXtra.com and
DispatchPolitics.com.
Subscribe
today!

If it seems your new prescriptions are filled quicker and with less hassle than used to be the
case, thank a Columbus technology firm for streamlining the process. CoverMyMeds, co-owned by Matt
Scantland, offers physicians and pharmacists across the country a free, online service to get quick
insurance approvals for new prescriptions.

Q: What initially sparked the idea for CoverMyMeds?

A: Back in 2008, Sam Rajan, who is today my co-founder, was in charge of the clinical programs
at one of the largest Medicare Part D (drug) plans. His clinical team discovered that the
prior-authorization process was causing patients to abandon their prescriptions — the complexity of
the process was resulting in patients failing to get the medicines they needed. Recognizing the
importance of getting and keeping patients on their prescribed medicines, we started CoverMyMeds to
streamline the prior-authorization process.

Q: Why is the prior-authorization process often difficult or time-consuming for physicians and
their staffs?

A: Prior authorization is the process of health-insurance companies requiring preapproval for
certain prescribed drugs. Preapproval has historically taken the form of paper, faxes and phone
calls. The concept is well-intended, but it is also one of the most-striking examples of
administrative waste in health care. More than eight hours of time per physician per week is spent
dealing with prior authorization.

The problem isn’t really that any one insurance company’s process is all that bad, but doctors
work with many health plans, and it is the diversity of these plans — each with their own slightly
different process and different communication methods — that makes the process so confusing.

CoverMyMeds simplifies this reality by sitting on top of all of these different processes to
create a single workflow for the provider.

Q: Are there benefits for pharmacists and patients, too?

A: Sure. Every pharmacist in the country has had to tell their patient, “I’m sorry, but your
drug isn’t covered.” CoverMyMeds changes this discussion by giving the pharmacist the ability to
digitally quarterback the process so they can say, “Your drug needed prior authorization, but I
just started the process and you’ll have your prescription right away.”

In the end, pharmacies can fill more prescriptions and deliver better customer service.

The ultimate beneficiary is the patient.

Q: Does using CoverMyMeds instead of a traditional paper or phone-based system typically speed
up the prior-authorization process?

A: Just like the technology you use to pay your bills online or to book an airline reservation
saves time on the phone, we do the same thing for prior authorization. We’re turning what used to
be a 20-minute process for the provider into a two-minute process.

Q: How does CoverMyMeds work? Is the software used primarily by physicians and pharmacists?

A: Yes, by pharmacists and physicians and their staffs. Our product is used by almost every
pharmacy in the country, from the big chains to the mom-and-pop pharmacies. We’re just as popular
in the doctor world, from the large hospital systems to the small primary-care doctor’s office.

Q: Is there a cost to physicians, pharmacists or patients?

A: No, our service is 100 percent free to physicians, pharmacists and patients. We think that is
important to ensure that our service is very broadly adopted.

Health plans and pharmaceutical companies each pay to support the service.

Q: How many prescriptions were filled last year using

CoverMyMeds? Can you estimate how many pharmacies (and/or physicians) are using the system now?
Is the company primarily serving the U.S.?

A: We just celebrated the 9 millionth patient who got on the drug they needed through our
service. The service operates just in the U.S. There are some opportunities to expand, but the way
that the insurance industry works here makes this the largest market for us today.

Q: What have you enjoyed most about this business venture?

A: We all want to have a part in making the world a little better than we found it. Prior
authorization is a pretty esoteric thing to those outside of health care, but if you are in the
doctor’s office, it is probably your least-favorite part of your job. And if you’re a patient,
getting through this process can be the difference between managing your illness and getting a
whole lot sicker.

We think we’ve had a part in making both of those things work a little better. Our motivation
comes from dozens of emails we get a week from our providers who tell us about how we helped them
take care of their patients and get a little time back in their day.